Implementation of Universal Pan-Cancer Germline Genetic Testing in an Arab Population: The Jordanian Exploratory
Hikmat Abdel-Razeq1,2, Baha' Sharaf1, Hira Bani Hani1
1King Hussein Cancer Center, Amman, Jordan.
JCO Global Oncology
|June 6, 2024
Summary
Universal germline genetic testing (GGT) in Jordan identified actionable pathogenic germline variants (PGVs) in cancer patients, including those outside standard criteria. This approach successfully impacted cancer care by uncovering crucial genetic information missed by guideline-based testing.
Area of Science:
- Oncology
- Genetics
- Public Health
Background:
- Germline genetic testing (GGT) is crucial for cancer care, but its universal application outside Western countries is understudied.
- Understanding GGT adoption in diverse populations is essential for equitable cancer management.
Purpose of the Study:
- To evaluate the feasibility and impact of universal GGT in a pan-cancer cohort in Jordan.
- To determine the frequency of pathogenic germline variants (PGVs) in patients meeting and not meeting established criteria.
- To assess changes in clinical management resulting from GGT.
Main Methods:
- 3,319 unselected Jordanian cancer patients underwent GGT between April 2021 and September 2022.
- Patients were categorized as in-criteria (IC) or out-of-criteria (OOC) based on 2020 NCCN guidelines.
- Statistical analysis, including Fisher's exact test, was used to compare PGV frequencies and evaluate management changes.
Main Results:
- The cohort was 69.9% female, with a mean age of 53.7 years; 53.1% were IC.
- PGV frequency was higher in IC (15.8%) versus OOC (9.6%) patients (P < .0001), but 34.8% of PGVs were found in OOC patients.
- Clinical management changes occurred in 57.3% of patients with high/moderate-risk PGVs, including 26.1% of OOC patients.
Conclusions:
- Universal GGT was successfully implemented in Jordan for newly diagnosed cancer patients.
- This strategy identified actionable PGVs that guideline-based testing would have missed.
- Universal GGT demonstrates potential for improving cancer care in non-Western settings.
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